Full Question:

I am a 51 year old woman in the middle of menopause. I have only had my period 1 full time this year and 2 other months with light spotting. What I have had was the Aura sometimes with the absence of the headache. The first time it happened I could not see out of my right eye and had all these jagged lines and I could not remember a darn thing. I was at work and looked down at my children's pictures on my desk and could not even remember there names. I was so freaked out my boss wound up taking me to the ER. Never so scared in my life. It lasted about 2 hours then I had a slight headache. This has happened a few times since where the Aura comes and then only a slight headache. Then there are other times where I get a severe headache on the right side over my eye with no Aura. Could any of this be contributed to the hormonal changes going on with the menopause or is it something more serious that I should worry about? When I went to the ER they gave me several injections and did CAT scan and a good neurological exam which all came out normal. I am pretty healthy. I do not drink any alcohol or smoke and limit my caffeine intake. I am 5'3 and weigh 125lbs. So over all I am in pretty good shape. What is your opinion? I went to my family doctor a few days after the ER visit by there direction and he gave me a prescription for (Fioricet) I hope I got that right hard to read his writing. He said there was a better one but due to the fact that I take Lexapro and Trazadone he did not want to combine those with the other drug.  So could you tell me what you think. I would greatly appreciate it.

Thanks, Denise.

Answer:

Dear Denise;

Migraines can indeed be triggered by the hormonal fluctuations of menopause.

Fioricet isn't considered the best first-line medication for Migraines. It cannot abort a Migraine (stop the Migrainous process in the brain). It can only mask the pain for a few hours. The "better one" that your doctor referred to was probably one of the triptans - Imitrex, Maxalt, Zomig, Amerge, Relpax, Axert, and Frova. There are warnings to be cautious when prescribing triptans for patients also taking antidepressants because of the possibility of serotonin syndrome.  Many doctors still feel the triptans are the better choice. They warn their patients of the symptoms of serotonin syndrome, and tell them to report any such symptoms immediately. Still, that's a decision for you and your doctor. You can read more about this in Antidepressants, Triptans, and Serotonin Syndrome.

Good luck,
John Claude Krusz and Teri Robert

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Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and Migraines. You can read more about Dr. Krusz or more about Teri Robert.